Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency o...Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.展开更多
AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute cholangitis.METHODS: Demographics, etiology of biliary obstruc-tion, clinical features, complic...AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute cholangitis.METHODS: Demographics, etiology of biliary obstruc-tion, clinical features, complications and associated systemic diseases of 175 patients with acute cholangitis were recorded. Endoscopic biliary drainage was performed using nasobiliary drain or stent. The complications related to ERCP, success of biliary drainage, morbidity, mortality and length of hospital stay were evaluated. RESULTS: Of 175 patients, 52 aged ≥ 60 years (groupⅠ, age < 60 years; group Ⅱ, age ≥ 60 years) and 105 were men. Fever was present in 38 of 52 patients of group Ⅱ compared to 120 of 123 in groupⅠ. High fever (fever ≥ 38.0℃) was more common in groupⅠ(118/120 vs 18/38). Hypotension (5/123 vs 13/52), altered sensorium (3/123 vs 19/52), peritonism (22/123 vs 14/52), renal failure (5/123 vs 14/52) and associated comorbid diseases (4/123 vs 21/52) were more common in group Ⅱ. Biliopancreatic malignancy was a common cause of biliary obstruction in group Ⅱ (n = 34) and benign diseases in groupⅠ(n = 120). Indications for biliary drainage were any one of the following either singly or in combination: a fever of ≥ 38.0℃ (n = 136), hypotension (n = 18), peritonism (n = 36), altered sensorium (n = 22), and failure to improve within 72 h of conservative management (n = 22). High grade fever was more common indication of biliary drainage in groupⅠand hypotension, altered sensorium, peritonism and failure to improve within 72 h of conservative management were more common indications in group Ⅱ. Endoscopic biliary drainage was achieved in 172 patients (nasobiliary drain: 56 groupⅠ, 24 group Ⅱ, stent: 64 groupⅠ, 28 group Ⅱ) without any significant age related difference in the success rate. Abdominalpain, fever, jaundice, hypotension, altered sensorium, peritonism and renal failure improved after median time of 5 d in 120 patients in groupⅠ(2-15 d) compared to 10 d in 47 patients of group Ⅱ (3-20 d). Normalization of leucocyte count was seen after a median time of 7 d (3-20 d) in 120 patients in groupⅠcompared to 15 d (5-26 d) in 47 patients in group Ⅱ. There were no ERCP related complications in either group. Five patients (carcinoma gallbladder n = 3, CBD stones n = 2) died in group Ⅱ and they had undergone biliary drainage after failure of response to conservative management for 72 h. There was a higher mortality in patients in group Ⅱ despite successful biliary drainage (0/120 vs 5 /52). Length of hospital stay was longer in group Ⅱ patients (16.4 ± 5.6, 7-30 d) than in groupⅠpatients (8.2 ± 2.4, 7-20 d).CONCLUSION: Elderly patients with acute cholangitis have a high incidence of severe cholangitis, concomitant medical illnesses, hypotension, altered sensorium, peritonism, renal failure and higher mortality even after successful biliary drainage.展开更多
This is a case report of an 85-year old patient who presented with abdominal pain, nausea and vomiting associated with altered liver function test. The plain X-rays and CT scan showed pneumobilia with an ectopic galls...This is a case report of an 85-year old patient who presented with abdominal pain, nausea and vomiting associated with altered liver function test. The plain X-rays and CT scan showed pneumobilia with an ectopic gallstone.The patient was diagnosed with Bouveret syndrome and managed surgically. The report is followed by a discussion about Bouveret syndrome.展开更多
文摘Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.
文摘AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute cholangitis.METHODS: Demographics, etiology of biliary obstruc-tion, clinical features, complications and associated systemic diseases of 175 patients with acute cholangitis were recorded. Endoscopic biliary drainage was performed using nasobiliary drain or stent. The complications related to ERCP, success of biliary drainage, morbidity, mortality and length of hospital stay were evaluated. RESULTS: Of 175 patients, 52 aged ≥ 60 years (groupⅠ, age < 60 years; group Ⅱ, age ≥ 60 years) and 105 were men. Fever was present in 38 of 52 patients of group Ⅱ compared to 120 of 123 in groupⅠ. High fever (fever ≥ 38.0℃) was more common in groupⅠ(118/120 vs 18/38). Hypotension (5/123 vs 13/52), altered sensorium (3/123 vs 19/52), peritonism (22/123 vs 14/52), renal failure (5/123 vs 14/52) and associated comorbid diseases (4/123 vs 21/52) were more common in group Ⅱ. Biliopancreatic malignancy was a common cause of biliary obstruction in group Ⅱ (n = 34) and benign diseases in groupⅠ(n = 120). Indications for biliary drainage were any one of the following either singly or in combination: a fever of ≥ 38.0℃ (n = 136), hypotension (n = 18), peritonism (n = 36), altered sensorium (n = 22), and failure to improve within 72 h of conservative management (n = 22). High grade fever was more common indication of biliary drainage in groupⅠand hypotension, altered sensorium, peritonism and failure to improve within 72 h of conservative management were more common indications in group Ⅱ. Endoscopic biliary drainage was achieved in 172 patients (nasobiliary drain: 56 groupⅠ, 24 group Ⅱ, stent: 64 groupⅠ, 28 group Ⅱ) without any significant age related difference in the success rate. Abdominalpain, fever, jaundice, hypotension, altered sensorium, peritonism and renal failure improved after median time of 5 d in 120 patients in groupⅠ(2-15 d) compared to 10 d in 47 patients of group Ⅱ (3-20 d). Normalization of leucocyte count was seen after a median time of 7 d (3-20 d) in 120 patients in groupⅠcompared to 15 d (5-26 d) in 47 patients in group Ⅱ. There were no ERCP related complications in either group. Five patients (carcinoma gallbladder n = 3, CBD stones n = 2) died in group Ⅱ and they had undergone biliary drainage after failure of response to conservative management for 72 h. There was a higher mortality in patients in group Ⅱ despite successful biliary drainage (0/120 vs 5 /52). Length of hospital stay was longer in group Ⅱ patients (16.4 ± 5.6, 7-30 d) than in groupⅠpatients (8.2 ± 2.4, 7-20 d).CONCLUSION: Elderly patients with acute cholangitis have a high incidence of severe cholangitis, concomitant medical illnesses, hypotension, altered sensorium, peritonism, renal failure and higher mortality even after successful biliary drainage.
文摘This is a case report of an 85-year old patient who presented with abdominal pain, nausea and vomiting associated with altered liver function test. The plain X-rays and CT scan showed pneumobilia with an ectopic gallstone.The patient was diagnosed with Bouveret syndrome and managed surgically. The report is followed by a discussion about Bouveret syndrome.
